Child ; Evidence-Based Medicine ; Guidelines as Topic ; Humans ; Nephrotic Syndrome ; diagnosis ; therapy ; Steroids ; therapeutic use

Objective To investigate whether caspase-8 regulates Bcl-2 expression in Fas and Actinomycin D(AD) induced apoptosis in Bel-7402 cells.Methods Bel-7402 cells were divided into four groups randomly,that is:control,Fas group,Fas-AD group and Ac-IEFD-cho group,and treated with Fas-AD in the presence/absence of caspase-8 inhibitor Ac-IEFD-cho.The expressions of caspase-8 and Bcl-2 were determined with Western Blot and RT-PCR,respectively.Results Compared with control group and Fas group,after Bel-7402 cells were treated with Fas-AD,typical apoptosis morphology was clearly observed,the expression of activated caspase-8 increased significantly,and the Bcl-2 expression decreased apparently.However,after Bel-7402 cells were treated with Fas-AD in the presence of the caspase-8 inhibitor Ac-IEFD-cho,the expressions of activated caspase-8 decreased while the Bcl-2 expression increased.Conclusion Activated caspase-8 can regulate Bcl-2 in Fas-and AD-induced apoptosis in Bel-7402 cells.

Objective To evaluate the visual function before and after photodynamic therapy(PDT) in patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods Twenty-five consecutive patients (34 eyes) treated with PDT (verteporfin) for subfoveal CNV in age-related macular degeneration diagnosed by fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Visual function including best corrected visual acuity, contrast sensitivity frequency, binocular function, confusion, stereo-vision, color vision, metamorphopsis and central scotoma were examed before photodynamic therapy and 1 week, 1 month, 3 month after photodynamic therapy. The follow-up time varied from 3 months to 2 years (mean 7.6 months). Results The changes of visual function at the 3rd month after photodynamic therapy revealed improving in 13 eyes (38.24%), without any change in 17 eyes (50.00%), and decreasing in 6 eyes (17.65%). Visual acuity with logMRA improved after photodynamic therapy, but without statistic difference. All spatial contrast sensitivity improved. Contrast sensitivity for spatial frequencies 5 cycles per degree (cpd) was better after photodynamic therapy with significant difference (P=0.045).Binocular function, fusion function, stereo function and color vision were slightly improved without statistic difference. Conclusion Damage of visual function in macular degeneration is many-sided. The treatment of PDT for exudative AMD can improve part visual function.

Objective To evaluate the therapeutic effect and safety of inhaling magnesium sulfate on infants with acute bronc-hiolitis. Methods Ninty infants with bronchiolitis were divided into 3 groups randomly and received either magnesium sulfate infusion inhalation or intravenous injection or normal saline inhalation respectively. The change of parameters of each group were observed and compared. Results Magnesium sulfate inhalation group and intravenous injection group were superior to control group in terms of the improvement of blood gas, clinical scores, continuous time of symptoms,signs, hospital days and clinical total efficiency(P

Objective To investigate the efficacy of autologous peripheral hematopoietic stem cell transplantation in the treatment of adult dermatomyositis. Methods A 21-year-old patient with dermatomyositis received autologous peripheral hematopoietic stem cell transplantation and was followed up for 6 years. Autologous peripheral hematopoietic stem cells were mobilized by recombinant human granulocyte colony stimulating factor (rhG-CSF) before the transplantation, and the conditioning regimens consisted of cyclophosphamide,methylprednisolone and cyclosporin. Rabbit anti-human T lymphocyte immunoglobulin began to be applied on day 3 after retransfer of stem cells. The improvement in symptoms, physical signs and biochemical indicators was observed, and hematopoietic restructuration and immunity resurrection were evaluated after the transplantation. Results After the transplantation, skin eruption greatly improved and gradually subsided. The muscle force of extremities restored from level Ⅳ before transplantation to level Ⅴ. The level of creatine kinase declined sharply after transplantation, but gradually returned to previous level. Leucocyte count began to decrease on the day of retransfer, and returned to the normal level on day 8. Immune function remained normal before and after the transplantation. Conclusion Autologous peripheral hematopoietic stem cell transplantation is an alternative treatment for severe and refractory dermatomyositis.

Objective This article was designed to observe the effects of astragalus polysaccharides (APS) on glucose and lipid metabolism, and on expressions of proxisome proliferator activated receptors-α (PPAR-α) and its downstream genes in diabetic hamsters cardiomyopathy. Methods Forty-five hamsters were divided into 3 groups randomly: normal control group (15 normal hamsters), diabetic control group [15 streptozotocin (STZ)-induced diabetic hamsters], and astragalus polysaccharides (APS)-therapy group (15 STZ-induced diabetic hamsters administered with APS 2 g/kg per day orally for 10 weeks). The levels of insulin, C-peptide, myocardial enzymes, glycosylated serum protein (GSP) and lipoprotein of all hamsters were measured. The ultrastructure of myocardium was studied, and the gene and protein expressions of PPAR-α, FATP and ACS were also detected by fluorescent quantitative RT-PCR and Western blot. Results It was shown that Compared with DM group, the levels of GSP, myocardial enzymes and lipoprotein of hamsters in APS-therapy group were lower, the myocardial ultrastructure of hamsters in APS-therapy group was well-protected, and the gene and protein expression of PPAR-α, FATP and ACS of hamsters in APS-therapy group were higher. Conclusions APS is partly effective in treating diabetic cardiomyopathy.

Objective To explore the role of transcription factors such as nuclear factor-kappa B(NF-?B) and glucocorticoid receptor(GR) in the pathogenesis of Adriamycin(ADM)-induced nephrosis in rats and the therapeutic effects of dexamethasone(Dex) and cyclosporin(CsA) on these animals.Methods The DNA-binding abilities of NF-?B and GR in cortex of kindey were examined with electrophoretic mobility shift assay(EMSA) and isotopic radioautography on the 7th,14th,21th and 28th day after a single intravenous injection of ADM,and the therapeutic effects of Dex and CsA were estimated.The biochemistry parameters from blood and urine of rats and the urine protein excretion were also measured.Results The NF-?B DNA-binding ability was significantly increased after 7 days and achieved maximum after 28 days(P0.05).Conclusion The DNA-binding ability of NF-?B is abnormally increased and that of GR is decreased in cells from cortex of kindey in Adriamycin-induced nephrotic rats.The NF-?B DNA-binding ability can be inhibited and the urine protein excretion is decreased by the treatment of CsA.

Objective To assess influences of hemoglobin variants on different HbA 1c measurement systems.Methods HbA1c values of normal samples and samples with hemoglobin variants were measured respectively byenzymatic assay (Norudia N HbA1c,SEKISUI), immunity transmission turbidity (oneHbA1c FS,DiaSys), boronate affinity HPLC(Ultra2,Trinity Biotech), capillary electrophoresis(Capillary 2 Flex Piercing,Sebia)and ion exchange HPLC(HA8160,Arkary;Variant Ⅱ Turbo(VⅡ-T),Bio-Rad;Variant ⅡTurbo 2.0 (VⅡ-T 2.0), Bio-Rad).HbA1c values from different hemoglobin variants and HbA1c measurement systems were analyzed .Results The HbA1c values from the 7 HbA1c measurement systems were well correlatedin normal samples .For HbE heterozygote , the HbA1c values from VⅡ-T were divided into 2 groups comparing with CFP , and HbA1c differences between CFP and other measurement systems are minor except for HA8160 and VⅡ-T.The HbA1c values of homozygous HbE were given by Ultra 2 but CFP and VⅡ-T 2.0.The differences of HbA1c values from samples with J-Bangkok are much higher than those from the samples with other hemoglobin variants .The differences of HbA1c values from samples with all kinds of hemoglobin variants(Hb J-Bangkok, Hb J-Newyork, Hb G-Taipei and Hb G-Coushatta)are dramatic for VⅡ-T.For rare Kurosaki, CFP can give a hint that there existshemoglobin variant while measuring HbA 1c. Conclusions Capillary Flex 2 Piercingcan well recognize common hemoglobin variants . Different hemoglobin variants have different influences on different HbA 1c measurement systems.The influences of J-Bangkok among HbA1c measurement systems are more evident than the other common hemoglobin variants .

Objective To investigate effects of β-thalassemia on 8 HbA1c measurement systems including Capillary electrophoresis and application of HbA2 values of samples with β-thalassemia from Capillary 2 Flex Piercing HbA1c measurement systems.Methods 338 samples without β-thalassemia ( include 80 α-thalassemia with --SEA/ααgenotype) and 225 samples with β-thalassemia were collected in Peking University Shenzhen hospital from January 2014 to August 2014.Samples withβ-thalassemia are all heterozygotes with normal α-globin and abnormal β-globin, and without combining other haemoglobinopathies.76 normal samples and 76 samples with β-thalassemia were selected from above all samples, HbA1c values of which were given by capillary electrophoresis ( Capillary Flex 2 Piercing), enzymatic ( Norudia N HbA1c ), immune transmission turbidity ( oneHbA1c FS ), chemiluminescent immunoassay (ARCHITECT HbA1c Reagent Kit), boronate affinity HPLC (Trinity Ultra2)and ion exchange HPLC (HA8160, VariantⅡTurbo and Variant Ⅱ BioRad 2.0), respectively.HbA1c values given by the eight systems were compared.338 samples without β-thalassemia and 225 samples with β-thalassemia were measured by using Capillarys 2 Flex Piercing HbA1c system and capillary electrophoresis hemoglobin system, the cut-off values of HbA2 from Capillary 2 Flex Piercing HbA1c measurement system for β-thalassemia was
assessed by using ROC curve.Data statistics were done by using SPSS 19.0.Results The HbA1c values of normal samples were well correlated with the comparative system.The correlation coefficients for the 7 systems are all greater than 0.98.For samples withβ-thalassemia, the correlation coefficients are all greater than 0.98 except for Variant Ⅱ Turbo.The bias between normal samples and samples with β-thalassemia have no significant difference except for VariantⅡTurbo.HbA2 values from Capillary 2 Flex Piercing HbA1c measurement and capillary electrophoresis hemoglobin system were well correlated. The correlation coefficient is 0.993.When cut-off value of HbA2 from Capillary 2 Flex Piercing HbA1c measurement system for β-thalassemia is 3.38, sensitivity is 98.3%, specificity is 100% .Conclusions Samples withβ-thalassemia have no significant effects on HbA1c measurement syetems except for Variant Ⅱ Turbo.The Capillary 2 Flex Piercing HbA1c measurement syetem has the advantage of screeningβthalassemia by HbA2 while measuring HbA1c.

Objective To evaluate the early emergency management process for severe pelvic fractures combined with multiple trauma. Methods The study involved 113 patients with severe pelvic fractures combined with multiple trauma treated from January 2007 to May 2011.The patients were divided into two groups,ie,before trauma team establishment (26 patients treated from January 2007 to May 2008) and after trauma team establishment (87 patients treated from June 2008 to May 2011 ) in accordance with the establishment period of trauma team in June 2008.The mortality was compared before and after application of trauma-team-based algorithm with damage control resuscitation,external fixation and angiographic embolization.Variables including age and gender distribution,ISS score,injury type and mechanism,transportation time,associated injury number,initial systolic pressure hemoglobin and blood transfusion were analyzed for study of their relation with mortality. Results After trauma team establishment,the mortality (23％) was significantly lower than before trauma team establishment (46％).The mortality showed significant relation to ISSN score and over two regions of associated injury,but showed no correlation with age and gender distribution,injury type and mechanism,transportation time initial systolic pressure hemoglobin,and blood transfusion. Conclusion The application of trauma team is effective in treatment of severe pelvic fractures combined with multiple trauma and can decrease the mortality.